Overview

Heavy flows and achy cramps can be a common experience when many women have their periods. Periods that prevent you from doing everyday activities aren’t normal. Each woman’s menstrual flow and cycle are different. It may be hard to know if your period is normal, light, or heavy unless you talk with your doctor.

Women lose an average of 30 to 40 milliliters of blood during a period. Women with heavy bleeding may lose 60 milliliters or more but not usually more than 80 milliliters.

Women who do experience abnormally heavy menstrual bleeding may have a condition called menorrhagia. This condition causes flows so heavy you need to change your tampon or pad every hour. You may also use more than six or seven tampons a day.

This condition can cause anemia and severe cramps. You may also pass blood clots larger than a quarter during your period.

Because measuring your total blood loss is impractical, the best way to know if your period is unusually heavy is to talk with your doctor. Together, you can review your period’s symptoms, conditions that might be causing greater bleeding, and what can be done to treat it.

What causes a heavy period?

Several conditions or issues can cause heavy periods. These heavy periods may occur frequently, or they may be more sporadic.

A period that’s suddenly very heavy one month

Ectopic pregnancy

The signs and symptoms of an ectopic pregnancy may be confused with a heavy menstrual period. This type of pregnancy develops outside your uterus and is rarely sustainable. It can cause severe health issues, including heavy bleeding and severe cramping.

Miscarriage

During and surrounding a miscarriage, heavy bleeding is common and may be mistaken for a very heavy period.

Nonhormonal intrauterine device (IUD)

Heavy menstrual bleeding is a common side effect of a nonhormonal IUD. After a few months with your IUD, you may find that bleeding becomes less severe.

Medications

Blood thinners can lead to blood flow problems and heavier menstrual flow.

A period that is heavy on the first day

Many women experience heavier bleeding on the first day of a period and lighter bleeding on the last days. A heavy flow that might get in the way of your normal activities is unusual.

Birth control changes

If you recently stopped using hormonal birth control, your periods may be very heavy in the first days as your cycle adjusts to the hormone changes.

Medication changes

Like birth control, medications you take may interfere with your cycle and lead to heavy bleeding on the first day of your period.

A recurring period that is heavy and painful

If every period is heavy, painful, and difficult to work around, you may have underlying, long-term issues.

Hormone problem

Your body typically balances progesterone and estrogen, the two hormones that play the biggest roles in menstruation. Too much estrogen, however, can lead to thick uterine walls. This can cause heavy bleeding as the lining is eliminated during your period.

Bleeding disorder

Ten to 30 percent of women with heavy periods have a bleeding disorder, such as von Willebrand disease. These disorders can make it difficult to stop your bleeding.

Uterine polyps

These small growths on the lining of the uterus can make periods heavier.

Uterine fibroids

These noncancerous growths are usually larger than polyps. They typically develop inside your uterus and can cause heavier periods.

Certain cancers

Cancer in your uterus, cervix, and ovaries are rarely the sole cause of heavy bleeding but a heavier period may be a symptom.

Perimenopause

During this transition before menopause, you may experience hormonal changes and unusually heavy bleeding during your period.

Childbirth recovery

After you have a baby, heavy periods aren’t uncommon. These changes may be permanent or your period may return to a flow similar to what you had before getting pregnant.

When to see your doctor

If bleeding is so heavy that you must replace a pad or tampon every hour, talk with your doctor. Likewise, if your period prevents you from doing normal activities because of pain, cramping, and heavy bleeding, it’s time to see your doctor.

During a visit, your doctor may conduct a physical exam, health history, and record your symptoms. They may also order a biopsy or imaging tests to look more closely at your uterus.

It’s difficult to know if your period is considered normal or heavy without your doctor’s help. Your doctor will be your guide in the process of figuring out if an underlying issue is the reason for your heavy periods.

How is a heavy period treated?

Typical treatments for heavy periods focus on regulating blood flow. Some treatments can also eliminate symptoms such as pain and cramping. If an underlying condition is causing your heavy bleeding, treating it may eliminate your unusually heavy periods.

Typical treatments for heavy periods include:

  • Birth control. Birth control pills and hormonal IUDs may help balance hormones and control periods.
  • Over-the-counter pain medications. NSAIDs, such as ibuprofen and naproxen sodium, may help ease symptoms of a painful period and help reduce blood loss.
  • Prescription medication. Your doctor may prescribe certain prescription medications such as oral progesterone to help treat heavy periods.
  • Surgery. Removing polyps or fibroids may reduce bleeding and ease other painful period symptoms.
  • Dilation and curettage (D & C). If other treatments are not successful, your doctor may remove the outermost layers of the lining of your uterus during a D & C procedure. This helps reduce bleeding and lighten periods. This procedure may need to be repeated.
  • Hysterectomy. In extreme cases, removing your uterus entirely may be necessary. You will no longer have periods, and you will not be able to get pregnant after this procedure.

The bottom line

Every woman’s cycle is different. That’s why it’s hard to know if your periods are normal or heavy. Your doctor can help you understand where your periods fall on the spectrum, and they can also help you look for treatments.

It’s important you’re honest with your doctor about your periods and symptoms so they can find helpful solutions for you. There’s no reason to dread your period. Many good options can help you regulate and control it.